title: Maternal mortality in India: a 20-year study from a large referral medical college hospital, West Bengal.
abstract: OBJECTIVE
  The present study was carried out to analyze the maternal death rate and its changing trends over a 20-year period in a large referral/teaching institution in Eastern India.
  
  
  METHODS
  A retrospective analysis of maternal deaths was carried out from January 1986 to December 2005 at the Department of Obstetrics and Gynaecology, R. G. Kar Medical College and Hospital, Kolkata, India. Records were divided into four 5-yearly periods: 1986-1990; 1991-1995; 1996-2000; and 2001-2005, for comparison of the trends. The initial interval from 1986 to 1990 was chosen as the reference period.
  
  
  RESULTS
  The cumulative maternal mortality ratio (MMR) was 599.3 per 100 000 live births. Comparison between the first 5-year period (1986-1991) and the last (2001-2005) showed a statistical significant downward trend in MMR (683.6 vs 474.3; P < 0.001). Deaths due to direct causes are still the leading cause, accounting for 82.09% of total deaths. Hypertensive disorders (36.14%), hemorrhage (21.91%) and sepsis (19.54%) were still the major causes of direct obstetric deaths throughout the study period. Hypertensive disorders alone showed a substantial decline after the introduction of magnesium sulphate.
  
  
  CONCLUSIONS
  The fall in maternal mortality has been very slow.
authors.affiliation: Department of Obstetrics and Gynaecology, R. G. Kar Medical College and Hospital, Kolkata, India. drsubir69@yahoo.com
authors.forename: Subir Kumar
authors.initials: SK
authors.lastname: Bhattacharyya
authors.forename: Arup Kumar
authors.initials: AK
authors.lastname: Majhi
authors.forename: Subrata Lall
authors.initials: SL
authors.lastname: Seal
authors.forename: Sima
authors.initials: S
authors.lastname: Mukhopadhyay
authors.forename: Gourisankar
authors.initials: G
authors.lastname: Kamilya
authors.forename: Joydev
authors.initials: J
authors.lastname: Mukherji
mesh_terms: D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008428:Maternal Mortality / Q000639:trends*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000401:mortality; D012189:Retrospective Studies